1558325423 NPI number — MS. DEBRA L URQUHART ARNP

Table of content: MS. DEBRA L URQUHART ARNP (NPI 1558325423)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558325423 NPI number — MS. DEBRA L URQUHART ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
URQUHART
Provider First Name:
DEBRA
Provider Middle Name:
L
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHWENDEMAN
Provider Other First Name:
DEBRA
Provider Other Middle Name:
LEE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1558325423
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/08/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 862851
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32886-2851
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-847-4273
Provider Business Mailing Address Fax Number:
954-847-4542

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4800 W. HILLSBORO BLVD.
Provider Second Line Business Practice Location Address:
SUITE A-6
Provider Business Practice Location Address City Name:
COCONUT CREEK
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33073-4330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-481-9184
Provider Business Practice Location Address Fax Number:
954-481-9317
Provider Enumeration Date:
04/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  ARNP9178262 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: 0178042305 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 306386100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com